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NPI Code Detail

MEDICARE: HEAVENLY ANGELS HOME CARE SERVICES

MEDICARE: HEAVENLY ANGELS HOME CARE SERVICES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251E00000XHome Health Agency
2253Z00000XIn Home Supportive Care Agency
3372600000XAdult Companion
4376J00000XHomemaker

General Provider Information

NPI Number : 1275035826
Entity Type Code : Organization
Provider Name (Legal Business Name) : HEAVENLY ANGELS HOME CARE SERVICES
Provider Business Mailing Address
First Line : 5609 PELLA POMPANO ST
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89031-3697
Country : US
Telephone Number : 702-778-7440
Fax Number : 702-463-7527
Provider Business Practice Location Address
First Line : 5609 PELLA POMPANO ST
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89031-3697
Country : US
Telephone Number : 702-778-7440
Fax Number : 702-463-7527
Authorized Official
Title or Position : OWNER
Name : LUCY FAJARDO
Credential :
Telephone Number : 702-778-7440
Provider Enumeration Date : 02/28/2018
Last Update Date : 01/02/2026

Similar Medicare Providers

1629910401 — LOURDES GLORIA
Practice Location Address:
5609 PELLA POMPANO ST
NORTH LAS VEGAS, NV
89031-3697
Practice Phone: 702-778-7440
Practice Fax: 702-463-7527
1285382671 — TANJAE HILL
Practice Location Address:
5609 PELLA POMPANO ST
NORTH LAS VEGAS, NV
89031-3697
Practice Phone: 702-778-7440
Practice Fax:
1801532650 — LINDA DZIEWULSKI
Practice Location Address:
5609 PELLA POMPANO ST
NORTH LAS VEGAS, NV
89031-3697
Practice Phone: 702-778-7440
Practice Fax:
1962120360 — KONJIT CHAKAW
Practice Location Address:
5609 PELLA POMPANO ST
NORTH LAS VEGAS, NV
89031-3697
Practice Phone: 702-778-7440
Practice Fax:
1295457380 — JAMAL JORDAN
Practice Location Address:
5609 PELLA POMPANO ST
NORTH LAS VEGAS, NV
89031-3697
Practice Phone: 702-778-7440
Practice Fax: 702-463-7527
1639892508 — JOCELYNN CHACON
Practice Location Address:
5609 PELLA POMPANO ST
NORTH LAS VEGAS, NV
89031-3697
Practice Phone: 702-778-7440
Practice Fax: 702-463-7527

Directions to “HEAVENLY ANGELS HOME CARE SERVICES ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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